By Kaitlyn Clark
The Haldimand Press
HALDIMAND—Ontario unveiled a multi-stage plan to loosen emergency measures and begin reopening the province on April 27, but it was unknown as of press time when exactly this plan would be put into motion.
The government noted there are many factors to consider before beginning this process. A range of set criteria may include:
- A consistent two-to-four week decrease in the number of new daily COVID-19 cases;
- Sufficient acute and critical care capacity, including access to ventilators and ongoing availability of personal protective equipment;
- Approximately 90% of new COVID-19 contacts are being reached by local public health officials within one day, with guidance and direction to contain community spread; and
- Ongoing testing of suspected COVID-19 cases, especially of vulnerable populations, to detect new outbreaks quickly.
Once these criteria are met, the province outlined the following stages to reopen:
- Stage 1: For businesses that were ordered to close or restrict operations, opening select workplaces that can immediately modify operations to meet public health guidance. Opening some outdoor spaces like parks and allowing for a greater number of individuals to attend some events. Hospitals would also begin to offer some non-urgent and scheduled surgeries, and other health care services.
- Stage 2: Opening more workplaces, based on risk assessments, which may include some service industries and additional office and retail workplaces. Some larger public gatherings would be allowed, and more outdoor spaces would open.
- Stage 3: Opening of all workplaces responsibly and further relaxing of restrictions on public gatherings.
“Recent public health indicators show us that we’re beginning to turn a corner in the COVID-19 outbreak, while economic data, feedback from businesses, and insights from our communities are outlining how we need to plan for economic recovery,” said Minister of Finance Rod Phillips. “Turning on an economy after an unprecedented shutdown is not as simple as flipping a switch. We need to plan this out carefully to ensure we do not spark a sudden outbreak, undo the progress we have made, and put the safety of the public at risk.”
HALDIMAND/NORFOLK—This chart summarizes the number of cases per day since the identification of the first case. Of note, there is some variability in the cases reported on any particular day (dark green bars). The light green line represents the cumulative frequency; this is the number of total cases as the pandemic progresses. For up-to-date statistics locally, visit hnhu.org/covid-19. —Courtesy of Haldimand Norfolk Health Unit.
Haldimand Norfolk’s Medical Officer of Health, Shanker Nesathurai, expressed similar viewpoints prior to the announcement.
“First and foremost, we have to continue to work on containment. It’s important for us to realize that sometime in the future we will withdraw these more assertive strategies, which restrict the movement of people and effectuate social distancing,” said Nesathurai. “But in making those decisions, the process has to be guided by some level of evidence. It will be a slow and gradual process. It requires some level of making risk-benefit determination as things open up.”
Nesathurai said that when they do move to open things, his priority would be “things that affect the quality of life of children and families”. The province announced April 26 that all publicly-funded schools would be closed until at least May 31, with learning at home continuing in the meantime as previously outlined.
Nesathurai urged caution in opening things too quickly: “The one thing I’m very concerned about is subsequent waves or secondary epidemics. As we relax restrictions, rural areas may be affected by migration from more endemic areas to rural areas, and rural areas in many ways are a challenge for health care resources…. I think we should be vigilant from a public health point of view.”
When asked about the possibility of reopening the province and when that should occur, Nesathurai said, “It’s hard to know what the future holds. I would hope, and this is my hope, that by June we have some semblance of relaxation for some of the restrictions we have imposed right now. It’s also my personal hope that I want my children to go back to school for September…. But you always have to temper that. If we get secondary spikes we may have to rethink it.”
Nesathurai warned of repeating the past, noting that during the SARS outbreak restrictions were “called off early and we had to reinstate them”, which he is concerned could happen again.
Haldimand Norfolk has seen restrictions put in place sooner or more strictly than some surrounding areas. Nesaturai noted that they will review every order as appropriate: “We want the orders to be consistent as best we can. Sometimes in Haldimand and Norfolk we take a more conservative stance than other health districts because of our circumstances, such as populations that may be vulnerable.”
While data for Haldimand Norfolk suggests the region is potentially flattening its curve of infection, Nesathurai remains cautiously optimistic.
“We’re always happy when we see less cases every day,” he said. “When you look at the data we had a peak on April 6 and another on April 14…. There’s always going to be peaks and troughs, peaks and troughs. I am hopeful we’ll have few cases every day, but the contextual issue is that we’re part of a larger province and people will travel back and forth.”
While Haldimand has had fewer new cases, the health unit has announced two new small outbreaks at local care homes. Parkview Meadows Christian Retirement Village in Townsend had an outbreak declared April 24 as two staff members tested positive, who are both in self-isolation at home. All residents have been tested, all tests came back negative, and no residents were reported to be sick. On April 26 Caressant Care Courtland LTC had an outbreak declared because one staff member had tested positive, who is also in self-isolation at home. All residents and staff are expected to be tested, but no residents were reported to be sick. Both homes have had a public health management plan initiated that follows the same advice given at Anson Place.
When asked why an outbreak was declared with only one or two staff members testing positive, Nesathurai stated, “Whenever we use the term outbreak it means we have a heightened sense of alertness. Technically the term outbreak under the current definition would include one staff member at an LTC facility.”
Under this definition, Norview Lodge in Simcoe also had an outbreak, but Nesathurai says it is now considered resolved. There have also been two suspected outbreaks among agricultural workers, and while measures are in place to avoid these potential outbreaks spreading, none of these cases were confirmed positive as of press time.
Haldimand War Memorial Hospital also announced April 27 that five residents at Edgewater Gardens were awaiting test results. Interim President and CEO Sharon Moore stated, “Since some people testing positive have no symptoms, while others have symptoms not typically associated with the virus, additional testing is being conducted at our hospital and long-term care home out of an abundance of caution.”
Ultimately, Nesathurai said the main goal continues to be containment by “identifying, isolating, and testing people who we think might have COVID-19” in order to “break the chain of transmission, to ultimately prevent it reaching an older person and hopefully preventing a death”.
Updates
April 27, 2020
HWMH announced after press time that all five of the residents who were tested at Edgewater Gardens came back negative.
“I’m relieved that our long-term care home, Edgewater Gardens, continues to have no residents testing positive for COVID-19,” says interim president and CEO Sharon Moore. “Many of these residents have complex health issues, and can have symptoms consistent with exposure to the virus. For this reason we are being very rigorous in our testing.”
Since COVID-19 testing began at both HWMH and Edgewater on March 11, 2020, a total of 103 swabs of patients and residents have occurred until the end of day on April 28. During the same time period, 71 swabs of staff members of both organizations were also taken. These numbers do not represent people tested, since some individuals were tested more than once.
Three of the four staff members who had tested positive for the coronavirus, as reported on April 9, have recovered after spending at least 14 days in self-isolation, becoming asymptomatic and having two consecutive negative swabs. These employees are returning to work under Ministry of Health infection control guidelines.
